WASHINGTON (CNS)—Now that the House has had its say on repealing
health reform, what are the next steps for those who would like to see
improvements to the Patient Protection and Affordable Care Act?

"Basic health care for all is a moral imperative, not yet completely
achieved," said the chairmen of three committees of the U.S. Conference
of Catholic Bishops, in a Jan. 18 letter to members of Congress.

The Republican-led House of Representatives voted 245-189 Jan. 19 to
repeal the health reform law, but the repeal is unlikely to be
considered by the Democratic-run Senate and would undoubtedly be vetoed
by President Barack Obama if it were to reach his desk.

For the U.S. Catholic bishops, it was never a question of whether to repeal or not repeal.

"Rather than joining efforts to support or oppose the repeal of the
recently enacted health care law, we will continue to devote our efforts
to correcting serious moral problems in the current law, so health care
reform can truly be life-affirming for all," said Cardinal Daniel N.
DiNardo of Galveston-Houston, Bishop Stephen E. Blaire of Stockton,
Calif., and Coadjutor Archbishop Jose H. Gomez of Los Angeles in the
letter.

The three chair the USCCB committees on Pro-Life Activities, on Domestic
Justice and Human Development and on Migration, respectively.

Just as they did during debate over the health reform legislation nearly
a year ago, the bishops identified three "moral criteria" that they
believe our health system must reflect:

-- "Access to quality, affordable, life-giving health care for all."

-- Protection of the conscience rights of health providers and a ban on
any federal funding of "elective abortions or plans that include them."

-- Continued access to health care for immigrants and the removal of existing barriers to access.

"We will advocate for addressing the current problems in the Patient
Protection and Affordable Care Act, as well as others that may become
apparent in the course of its implementation," the USCCB leaders said in
their letter.

Receiving strong support from the bishops is the No Taxpayer Funding for
Abortion Act, introduced Jan. 20 by Speaker of the House John Boehner
of Ohio and Rep. Chris Smith, R-N.J., with more than 160 co-sponsors.

Joining Smith at a Jan. 20 news conference on Capitol Hill were Rep. Dan
Lipinski, D-Ill., who co-chairs the Congressional Pro-Life Caucus with
Smith, and Rep. Joe Pitts, R-Pa., chairman of the Health Subcommittee of
the House Committee on Energy and Commerce and chief sponsor of the
Protect Life Act, which would amend the health reform law to ensure
there is not funding for abortion or abortion coverage.

"The health care law made it clear that the current way we prevent
taxpayer funding of abortion through annual riders is dangerously
fragile," said Lipinski. "We must take action to prevent federal funding
for abortion under the health care law and throughout the government,
without exception."

The House leadership also is taking another approach to improving—or
replacing— the health reform law. A resolution approved Jan. 20 by a
253-175 vote, including 14 Democrats, directed four House committees to
come up with legislation that would preserve some aspects of the law.

Among other things, the resolution said, the proposed legislation should
"lower health care premiums through increased competition and choice";
allow patients to keep their current doctors; give people with
pre-existing conditions access to affordable health coverage; increase
the number of insured Americans; and "prohibit taxpayer funding of
abortions and provide conscience protections for health care providers."

Others who want changes in the health reform law have taken a different tack.

At least two dozen lawsuits have been filed in federal court against
various aspects of the law. On Jan. 18, six more states joined in a
Florida-led effort to overturn the requirement that each American carry
health insurance by 2014 or pay a penalty to the government; now more
than half of the states are involved.

In December, U.S. District Judge Henry E. Hudson declared the mandate
unconstitutional in a separate lawsuit brought by the commonwealth of
Virginia. The Obama administration is appealing the ruling, and the
issue is expected to eventually reach the U.S. Supreme Court.

Other legal challenges—brought by individuals, political or civic
associations, small-business owners, and groups of physicians or
patients—find fault with the law's effects on Medicare or Medicaid
coverage, the possibility that it will cause an increase in taxes,
medical privacy concerns or other provisions.

Clearly, the final face of health reform is yet to be seen.

Faithful Reform in Health Care, a coalition of faith-based organizations
and people of faith, likened the transformation of the U.S. health
system to the modernization of the nation's infrastructure.

"We created a power grid, phone systems, water systems and interstate
highways that improved our life together and served the common good. ...
Our health system, however, still operates with the equivalent of
individual generators, scattered wells and meandering roads," the
coalition said in a document six months after the law passed.

"With a new vision and a shared commitment to fulfill it, we can create a
health care system that sustains our collective well-being," it added.
"The Affordable Care Act is the first step of this journey."